Researchers found economic insecurities, such as difficulties paying for food and medications, could be associated with poor diabetes control in patients.
The findings suggests increased access to health insurance provided by the Patient Protection and Affordable Care Act may not improve diabetes control among low-income individuals who encounter financial hardships, the JAMA Network Journals reported.
To make their findings the researchers looked at data taken between June 2012 and Oct. 2013 on 411 patients who were treated at two Massachusetts community health centers. Among the participants "19.1 percent of patients reported food insecurity; 27.6 percent cited cost-related medication underuse; 10.7 percent had housing instability; 14.1 percent had trouble paying for utilities (energy insecurity); and 39.1 percent of patients reported at least one material need insecurity," the journals reported. Poor diabetes control was observed in 46 percent of the study participants.
The team found food insecurity upped the likelihood of poor diabetes control (measured by hemoglobin A1c, low-density lipoprotein cholesterol level or blood pressure) and increased emergency department and inpatient visits in these individuals. Housing and utility insecurities were associated with increases outpatient visits, but not with diabetes control. Having a variety of economic insecurities was linked to both poor diabetes control and increased healthcare use.
"Health care systems are increasingly accountable for health outcomes that have roots outside of clinical care. Because of this development, strategies that increase access to health care resources might reasonably be coupled with those that address social determinants of health, including material need insecurities. In particular, food insecurity and cost-related medication underuse may be promising targets for real-world management of diabetes mellitus," the study concluded.
The findings were published in a recent edition of the journal JAMA Internal Medicine. The study was supported by an Institutional National Research Service award and other sources.
